Made up of....
Gingiva
Periodontal ligament
Alveolar bone
Root cementum
Functions of the periodontium Provide a seal around the cervical portion of the tooth
Holds the tissue against the tooth during mastication
Suspends and maintains the tooth in its socket
Protect the dentin
Surrounds and supports the root

Large leukocytes with one kidney-shaped nucleus and some granules found in the tissue

Chronic Inflammation

Long-lived inflammatory response lasting more than 2 weeks

Unattached Plaque

Free floating unattached bacteria

Col

Area directly below the contact

E series prostaglandins

Most destructive to bone

Phagosome

A phagocytic vesicle that surrounds bacterium

Monocytes

leukocytes found in the blood stream

Virulence factors

Mechanisms that enable biofilm bacteria to colonize, invade, and demage the tissue of the periodontium virelence factors may be structural characterists of the bacterium itself or substances produced and relaesed into the environment bacteria

Lipopolysaccharide
(endotoxin)

major component of gram -cell walls

Cytokines

Powerful mediators produced by immune cells that influence the behavior of other cells
Transmits Infomation

Periodontal disease

Bacertial infection of the periodontium

OMG
overlap, meet, gap

Overlap 60%
Meet 30%
Gap 10%

Gingivitis

bacterial infection limited to the gingiva

Periodontitis

A stage of periodontal disease effecting the gingiva, PDL, alveolar bone, and cementum

Disease site

An area of tissue destruction

Cell junctions

Cellular structures that mechically attach a cell and its cytoskeleton to its neighboring cells or to the basal lamina

Gingival Epithelium

A specialized stratified squamous epithelium that functions well in the wet environment of the oral cavity.

Hard, mineralized tissue that is 45-50% inorganic hydroxyapatite. It covers the root (dentin) and is usually light yellow in color. MORE RESISTANT TO RESORPTION THAN BONE and devoid of nerve and blood supply. It must receive nutrients from ligament

Epithelial tissue

•Epithelial tissue has stratified squamous epithelium

• Lines oral cavity

•Keratinized or parakeratinized except in the Sulcular epithelium where it is nonkeratinized

Understand and be able to discuss the role of GCF in the periodontal disease process.

pellicle

A thin coating of salvary protiens that attach to the tooth and form within minutes after cleaning

Phagocytosis

Process by which leukocytes engulf and digest microorganisms

Inflammation

the body's reaction to injury or invasion of pathogens or tissue injury

Edema fluid

Fluid that accumlates in the tissue

Bacterium/bacteria

Simplest bacteria that can be seen through a microscope

Host

An infected individual. in the case of periodontitis, the host is an individual with periodontitis

Remission

Signs or sympotoms of a chronic infection at times that may partially or completely disappear

Phagolysosome

Lysosome granules that fuse within the vesicle digesting the bacterium

Periodontal pocket

pathological deepening of the gingival sulcus with apical migration of the junctional epithelium, distruction of PDL, and destruction alveolar bone

Pathogenesis

The sequence of events that occur during the development of a disease or abnormal condition

Dehiscence

Cleft defect in the cortical bone which includes the margin of the bone.
Prominent root contour
Malalignment of teeth
Loss of attached gingiva
Severe periodontal disease
Abscess
Cyst
Defects of the cortical bone

Inactive disease site

Disease site that is stable

Free gingiva groove

Linear depression that separates free and attached gingiva. Clinically visible 24-43% of the time and most common in Mand. anteriors, premolars Attached gingiva

Epithelial ridge

Deep extensions of epithelium that reaches down into the connective tissue. The epithelia ridges are also known as rete pegs

Oral Epithelium

Epithelium that covers the outer surface of the free gingiva and attached gingiva....it extends from the gingival margin to the mucogingival junction

Keratinized Layer

Made up of Keratinized and Nonkertinized layers
Keratinized layers are stronger and waterproof

What type of tissue makes up enamel?

epithelial

Anarobic bacteria

Cannot live in the presence of air

Bacterial enzymes

Agents that are harmful or destructive to host cells

increase permeability of the epithelial lining

breakdown of collegen fibers in the gingival

promote apical migration of JE

widening of the intercellular space

diminished ability of immunoglobulins and other body proteins

Gram postive bacteria

Bacteria w/ a thick single wall

Complement System

Series of proteins circulating in the blood that work to facilitate phagocytosis or kill bacteria by puncturing the cell membrane

Opsonization of pathogens

The process of coatinga microoragism with antibodies or a complement protient to make it easier for phagocytes to recognize, engulf, and destroy it.

Lymphocytes

small WBC that play an important role in recognizing and controlling foreign invaders

Acute inflammation

Inflammation respose of 2 weeks or less

Understand and be able to discuss the role of saliva in the periodontal disease process.

Matrix metalloproteinases
MMP

12 different enzymes that breakdown connective tissue. Produced by PMN's

Histology

A branch of anatomy concerned with the study of the microscoptic structure of tissue

Connective tissue

Fills the space between the tissues and organs in the body. It is made up of a large amount of material that surrounds the cell

Free Gingiva

The unattached portion of the gingiva that surrounds the toothin the region of the cementoenamel junction

Gingival pocket

deeping pocket that is enlarged due to inflammation

Alveolar crest

The most coronal portion of the alveolar process. in health the crest is located 1 -2 mm apical to the CEJ

Gingival tissue is specialized to function in a wet environment because it is made up of......... and those 3 areas are called?

Forms by the uneven distribution of bacteria that attaches to the surface by a stem or root

Incidence

# of new disease cases in a population that occur during a given interval.

External basal lamina

A thin mat of extracellular matrix between the epithelial cells of the JE and the gingival connective tissue

Periodontal Ligament
PDL

a layer of soft connective tissue that covers the root of the tooth it attaches it to the bone of the socket

Extracellular Ground Substance

Is a meshlike material that surrounds the cell

Epithelium-connective tissue interface

The boundary where the epithelial and connective tissue meet
Wavy
Smooth

Describe Alveolar mucosa

Located on the apical boundary or lower edge of the gingiva. It can be distinguished easily from the gingiva by its dark red color and smooth shiny surface. Nonkertinized stratified squamous epithelium. Loose, freely movable, highly vascular, made up of elastic fibers

 Microflora more anaerobic, more gram -, more motile, more asaccharolytic

Main cause of tissue destruction related to periodontitis

Host response of inflammatory process

Be able to identify and discuss the 2 cells involved in the immune response that are responsible for phagocytosis

• Polymorphonuclear (PMN) or neutrophils and Macrophages

immune response

A complex system in the body that is responsible for fighting disease

Junctional Epithlium (JE)

Epithlium that forms the base of the sulcus and joins the gingiva to the tooth surface

Interproximal bone

The area of bone that lies between the proximal surfaces of two teeth surface. The interproximal bone is also known as the interdental septum

What are Sharpey's fibers?

Fingerlike projections off of the PDL that adhear to the cementum and alveolar the harden when they become intrapped in the bone that forms around them

What is the CEJ %

overlap 60% cementum overlaps the enamel
meet 30% the cementum and enamel meet
gap 10% a small gap between the enamel and cementum

Of these three types of plaque whichis the easest to remove and which is the most diffucult: tooth-attached, epithelial-attached and unattached plaque?

Tooth-attached the most difficult
Unattached plaque the easiest

What bacteria is responsible for lipopolysaccharides?

Gram - only after the lysis

Alveolar bone proper

The thin layer of bone that lines each alveolus

Apical migration of the junctional epithelium

Occurs when the PDL bundle is broken

Discuss the similarities and differences between acute and chronic inflammation.

Acute has symptoms and only lasts a few weeks/Chronic few to no symptoms and lasts more than a few weeks

Of the mostly extracellular matrix found in connective tissue what 2 materials make up 65% and #5% respectively?

65% is protein fibers ie. collagen
35% gellike material

What is the benefit of a wavy boundary between epithelial and connective tissue?

Increase surface area.....
increasing adhesion
increasing nourishment

What is the hemidesmosomes in epithelial tissue around the coronal and apical portins of the teeth?

4-8 hemidesmosomes per micron in the coronal portion
2 hemidesmosomes in the apical region

Discuss the role of prostaglandins in the progression of periodontitis

Initiate most of the alveolar bone destruction in periodontitis
Trigger increased osteoclast activity
Increase the permeability and dilation of the blood vessel, leading to redness and edema of the connective tissue

Be able to discuss the signs of inflammation and how they relate to the immune response.

Heat: Increase of blood at the site
Redness: Increase blood at the area
Swelling: Fluid accumulation at the site in the form of leukocytes/plasma
Pain: Excess fluid build-up puts pressure on nerves
Loss of function: Swelling and pain

What are the functions of the periodontal ligament?

A soft connective layer of tissue that covers the root of the tooth and attaches it to the bone of the root socket.Support, sensory, nutritive, formative, resorptive

Of the 3 epithelial tissues which are keratinized and which are not?

JE and SE are nonkeratinized
OE is keratinized

Be able to identify the cytokines( cell protein) that play a role in the initiation and progression of periodontal disease.

Works as a signal to other cells to send additional phagocytic cells to the site of infectionThis increases the vascular permeability that leads to increased movementHas the potential to initiate tissue destruction and bone loss in chronic inflammatory disease such as periodontitisInterleukin-1 (IL-1), (IL-6), (IL-8), and tumor necrosis factor-α (TNF- α)

A) During a short period of a program execution memory references tend to cluster around a certain location. ||| ||| ||| ||| ||| ||| ||| |||
B) A program is generally composed of several different localities and these localities shift slowly. ||| ||| ||| ||| ||| ||| ||| |||
C) Localities are influenced by the program’s control structure (i.e., a loop) and by its data structure (i.e., an array).